Basic Information
| Provider Information | |||||||||
| NPI: | 1497939292 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLUMB | ||||||||
| FirstName: | SHELLEY | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2326 S CONGRESS AVE | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334067617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614335577 | ||||||||
| FaxNumber: | 5612752696 | ||||||||
| Practice Location | |||||||||
| Address1: | 2326 S CONGRESS AVE | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334067617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614335577 | ||||||||
| FaxNumber: | 5612752696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2007 | ||||||||
| LastUpdateDate: | 06/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | PO2724 | FL | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213ES0103X | PO2724 | FL | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.